I made it 2 1/2 years without having to deal with this. Thought my first surgery in May 2010 @ MD Anderson in Houston got it all. The doctor said clear margins and the scans showed nothing. It was originally under the bottom of my tongue on the right, don't remember any of the numbers size etc but it was not large. In January 2013 I noticed my right side neck had a swollen lymph node. Had some tests, PET Scan etc. The lymph node was necrotic and a PET Scan showed cancer there and in my left tonsil and possibly my left lymph node. My surgery is scheduled for March 8th and I am having my tonsils removed, the right side lymph nodes removed and an excision biopsy on my left lymph node. Assuming the left comes back positive the doctor will do a neck dissection on the left as well. I would guess that I will have to have radiation and chemo. I avoided radiation and chemo the first time, maybe I should have done it then and I would not have it now..... It is not HPV related. I have read some blogs that make this a not so pleasant experience. The first time was no fun either.